‘When or if’ to go to A&E with AF epi... - Atrial Fibrillati...

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‘When or if’ to go to A&E with AF episode and other general moans!

CentreHalfMum profile image
65 Replies

Hi everyone,

For the last 2 days I have been frantically decorating my bathroom as have relatives coming to stay from USA. Bear with me as I think the decorating issue may be relevant. Was absolutely exhausted and by 10pm last night was having AF episode.

To give a bit of background, I was diagnosed in 2019 and have been hospitalised and cardio verted twice. Thankfully I’ve had only 3 episodes since, usually waking in the middle of the night with AF. I use flecainide as ‘pill in pocket’ and so far this has worked. Since diagnosis I’ve only seen a cardiologist once shortly after my first episode and that was only because a clinician friend asked her colleague to see me as absolutely NO follow up has ever been forthcoming.

I had to consult the internet for instructions about using flecainide. It is impossible to see anyone in our GP surgery and they even close their Econsult system regularly! My questions are….at what point, if the ‘pill in pocket’ approach fails should you go to A&E or is it a 111 job? I have read on this forum, so many different pieces of advice people have received ie ‘don’t go unless heart rate is over 150 for at least 3 hours’ to ‘don’t bother with A&E as it’s usually pointless’. I just wondered what your experiences /advice would be?

Now back to the decorating…3 AF episodes ( two of which required cardioversion) occurred after doing painting, DIY etc is that coincidence, paint fumes, more strenuous activity? I was contorting myself trying to paint our small bathroom, could unusual body positions trigger AF?

sorry for the long post, just feeling totally fed up with AF today and frankly feel a bit neglected and abandoned by NHS. My GP (when I did manage to speak to them) said ‘you don’t need follow up for AF, just keep taking the medication’…..hmmm really??

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65 Replies
fibnum profile image
fibnum

Inhaling paint fumes is harmful to our body in general and that might include triggering Afib.

Vent the area, use exhaust fans and limit exposure as much as possible when using chemicals.

CentreHalfMum profile image
CentreHalfMum in reply tofibnum

Thankyou for your reply. I really try to reduce the use of horrible chemicals as far as possible in the house. However, 3 episodes linked to when painting, even though one was when painting garden furniture outside, seems slightly more than coincidence.

Avatel profile image
Avatel in reply tofibnum

I thought most modern paints were harmless?Although i could ne wrong

jeanjeannie50 profile image
jeanjeannie50

You asked when to go to hospital with AF. I would only go if it was making me feel ill (my GP advised when over 130bpm for more than a few hours). The way things are so busy in A&E these days, I would do my best not to go there. If feeling faint with it, or any chest pain, I'd be dialling 999.

I've had AF for 18 years, three ablations and numerous cardioversions.

Jean

CentreHalfMum profile image
CentreHalfMum in reply tojeanjeannie50

Thank you so much for your advice. I dread the thought of going into hospital and that adds to the general scary feeling AF induces. Spent over a month in hospital last year with very badly broken ankle ( shattered might be more accurate) 2 ops, caught covid despite being jabbed up. It was awful in there to be honest but the acute stress didn’t trigger my AF which was a pleasant surprise. You are quite right, avoid as much as possible! However just feel I needed advice about a plan B if ‘pill in pocket’ fails. Thankyou

ETHEL103 profile image
ETHEL103 in reply tojeanjeannie50

Jean I went to hospital for an ecg following fast heart run for weeks.Ecg said 135

Nurse phoned the cardiology dept and asked if i was in pain.No I replied OK.Cardio says you can go.Just shows how we all.experience hospitals differently.

jeanjeannie50 profile image
jeanjeannie50 in reply toETHEL103

Yes, I agree with you. I was once sent to A&E when my heart rate was 125ish. Another time was discharged from a ward to await a cardioversion when my heart was around that same rate. Another time when my heart was stuck at 150bpm I went to my doctors surgery and was told to go home and take another Flecainide and if that didn't work then go to A&E. At the time I didn't know that I also had an underactive thyroid which added to how poorly I felt.

There doesn't appear to be a general guide to help GP's make a decision, just as to when we should go to A&E, when our hearts play up. Perhaps it depends on what an ECG shows.

How did you feel when your heart rate was at 135bpm.

Jean

ETHEL103 profile image
ETHEL103 in reply tojeanjeannie50

I felt OK but I knew my heart was fast.It was laced with ectopics hence my kardia kept saying possible a fib.Up until I had my ablation in May I was down for a fib ablation.After the ep popped in very briefly to say all they could find was flutter.I was so shocked I thought for the 2 pandemic years I had developed a fib but as I have said previously being diagnosed during that time was impossible unless I guess I had gone to A&E.

Jalia profile image
Jalia

I would say that complete exhaustion was your trigger! Been there, done that, including the decorating!

Re going to A&E, how YOU are feeling is your best guide. Not other people. If you are feeling really compromised and your rate does not drop to , say under 120bpm at rest then a call to 111 would not be inappropriate.

I recently sat it out at home until my third day with fast AF starting at about 180bpm and settling in 140s later (at rest). When I eventually presented at A&E on the insistence of my GP they kept me in on CCU for 2 nights and then had electrical cardioversion.( my 23rd...) Maybe I'm lucky with my local hospital but I've always been treated promptly and well and never been made to feel a nuisance.

CentreHalfMum profile image
CentreHalfMum in reply toJalia

Thankyou for the advice, goodness me 23 cardioversions, you have certainly been through it. You are probably right about the exhaustion - why do we do it to ourselves?? My husband is in the ‘they take us as they find us’ school of hospitality but I got a right old panic on about the state of our house. It’s so stupid!

Jalia profile image
Jalia in reply toCentreHalfMum

I understand!!

Lizziedoodle89 profile image
Lizziedoodle89

Maybe coincidence but many years ago my dad was painting in a confined space and actually had a heart attack could be nothing to do with it but might have been?

CentreHalfMum profile image
CentreHalfMum in reply toLizziedoodle89

So sorry you lost your dad in that way. It does make you wonder and has put me off decorating for sure.

Finvola profile image
Finvola

The question of going to A&E is a matter of how ill you feel, heart rate and for how long, how much stress getting to the hospital involves and waiting to be seen. Had I followed my GP's well-intentioned advice, I would have practically lived in A&E for months on end! Consider too, what will A&E do with me? Probably take an ECG, monitor for a while and send you home.

I never went to A&E as the 45 minute journey and the waiting and crowding, even 10 years ago when I was having frequent episodes of fast AF, made me realise that I was probably less stressed out at home.

Having said all that - any chest pain or difficulty breathing needs an immediate call for help.

Paint fumes and white spirit used to bring on my AF every time. I used to do a lot of oil painting, using white spirit for colour washes and brush cleaning and had to find alternatives. I think that painting a room, bending over and putting pressure on your chest would affect your heart, especially if you are already tired and probably stressed from the task. I now avoid paint fumes and adhesive fumes - I have blamed both for heart rhythm disturbance.

CentreHalfMum profile image
CentreHalfMum in reply toFinvola

More great advice, many thanks. Interesting that paint fumes etc also affected you. I thought maybe I was coming up with a crazy theory but from the replies, obviously not.

BobD profile image
BobDVolunteer

Dehydration will likely be another reason. We tend to forget things like that when decorating so drink lots of water. As far as A and E is concerned, AF is neither an accident nor emergency and should be treated by either your cardiologist or GP. The only reason to go there would be if you are having fainting fits or chest pain. If people are not attending to your needs bang desks and make a nuisance of yourself till they do!

CentreHalfMum profile image
CentreHalfMum in reply toBobD

Righto Bob, will definitely flex the desk banging muscles. I cannot seem to get any action whatsoever from any GP, which is irritating as presumably they would have to refer me to cardiology. Surely AF patients should get some sort of follow up? I’ve read that annual blood checks should be offered at the very least, to review how medications are going? I’m on Bisoprolol, Apixaban and Candesartan. Are we supposed to be content to be prescribed these rather heavy duty drugs and then just take them for the next 20 years or so without review? Fully appreciate the need take them but it would be useful to think there is some monitoring and long term plan.

Finvola profile image
Finvola in reply toCentreHalfMum

As you are taking Apixaban you should have at least a yearly liver function blood test to ensure that the anticoagulant is being excreted properly. Your GP should have arranged this when you started the drug.

Peony4575 profile image
Peony4575 in reply toCentreHalfMum

I started Edoxaban on January 1st. Got a call from the practice pharmacist a month later who talked me through carrying the patient alert card, asked if I had any side effects, and told me to get in touch if I noticed anything . She said I would be having an annual blood test but I would be called in after two months for a blood test to check liver function, Us&Es, FBC to make sure nothing had been affected. Am starting to feel blessed with my GP practice !

CDreamer profile image
CDreamer in reply toCentreHalfMum

At least annual tests and one before you start taking any drug for base line level.

You really do need to bang desks. My suggestion would be write a letter of complaint to the Surgery Manager asking why this is not happening? Anything you say can be ignored or forgotten - letters must be answered.

I have blood tests every 3 months for the drug regime I am on.

Lainie2875 profile image
Lainie2875 in reply toCentreHalfMum

yes be wary of the drugs some cause more damage than they cure unless your in your 80s or 90s !!!

Jalia profile image
Jalia in reply toBobD

I don't entirely agree with you here Bob. If you are having prolonged episode of high rate AF which does not abate then A&E should be considered. I went into heart failure ....pulmonary oedema.....after 3 weeks of continuous 120/130 AF

CentreHalfMum profile image
CentreHalfMum in reply toJalia

The feeling of having an AF episode is just so vile. The horrid sensation in the chest, I wee constantly too and if that happens I just know it’s an episode without even having to check pulse. Just don’t know how people bear it for days, weeks or permanently- it’s just a horrible sensation and even after 4 years of relatively few episodes, it still feels scary.

CDreamer profile image
CDreamer in reply toCentreHalfMum

I know it sounds mad - but you do get used to it as the body gets used to all sorts of things - the more often it comes then the more you adjust. It’s about containing and managing the negative thoughts and once you accept although it often feels like you are dying - you are not and do survive then it just becomes unpleasant. I have been lucky as I have always self converted - eventually. Longest episode was about 3 days - then I did go to hospital. It’s not a binary answer as to whether or not to go to hospital and you do need guidance from an experienced doctor who knows your medical history and your treatment plan.

BobD profile image
BobDVolunteer in reply toCDreamer

Absoblooming lutely CD. and as we both know, there are far worse things to have than AF.

Lainie2875 profile image
Lainie2875 in reply toJalia

Absolutely

Tamgirl profile image
Tamgirl in reply toBobD

I have been to my local A&E a few times with high and fast variable heart rate. They have told me I absolutely should be there.

mjames1 profile image
mjames1

It's not the heart rate per say, but how you feel. With dizziness and shortness of breath it can be a judgement call, but if you have chest pain that you haven't experienced, call for help right away. And if in doubt, or if you feel unsafe, seek medical help.

About the heart rate. For me, and I'm just talking about myself, as long as I get my resting heart rate down to 110 or below (ideally 100 or below) and my moving around heart rate to 120 or below (ideally 110) I feel pretty comfortable and have ridden out afib events for up to a week at this rate, more or less going about my business -- walking to the store, etc.

To do this, I used a rate control drug diltiazem and sometimes a little beta blocker. That said, if I didn't convert by day 5-7, I would be on the phone to my ep discussing cardiovertion, because once you hit day seven in afib, you're entering "persistent" territory.

Since I've started Flecainide, my longest episode was 7 hours, but if I didn't convert, my plan would be to get my rate down as described above, then try the PIP the next day and the next if that didn't work. By day 5-7, I would start thinking about cardioversion.

The stress of company plus finishing up a bathroom could put anyone in afib.

Jim

CentreHalfMum profile image
CentreHalfMum in reply tomjames1

Love the last sentence. To be horribly honest, can’t stand having house guests who stay. Think it was Mark Twain who said ‘fish and company start to smell after 3 days’

BobD profile image
BobDVolunteer in reply toCentreHalfMum

I think it was Noel Coward who said "Some people light up a room when they enter. Others when they leave!" I know too many of the latter. lol 😁

Jalia profile image
Jalia in reply toBobD

Love that quote Bob.....I shall remember to use it !!

Jalia profile image
Jalia in reply toCentreHalfMum

I agree! In days of yore we didn't mind who stayed over and never gave it a second thought. Our only overnighters now are little grandchildren on sleepovers !

CDreamer profile image
CDreamer in reply toCentreHalfMum

Then why agree to having them? Use your AF as an excuse!

Whether we are the visitors or hosts - 3 day rule has always applied. Love the quotes and will remember both!

BobD profile image
BobDVolunteer

I have just had my annual blood test to check the usual parameters and will have my annual consultation on 16th March albeit with a "clinical scientist" whatever that may be. ( also have regular contact with my EP in London.) Under NICE guidelines if your GP cannot help control your symptoms you have the right to see an arrhythmia specialist which may be either a cardiologist or maybe just an arhhythmia nurse specialist. Only consultants can prescribe anti-arrhythmic drugs such as flecainide or propafanone.

Elizka profile image
Elizka

I personally would want a more detailed cardio workup such as a stress test, etc. That said, over doing it can cause AF and it has for me.

pusillanimous profile image
pusillanimous in reply toElizka

I was interested to read about the possibility of a stress test. I see the Cardio annually, and am attached to his fancy machines, scanner plus doppler etc. but never has a Cardio (I have seen 3 different ones for geographical reasons, moving etc) got me to do the stress test. This is in South Africa.

Peony4575 profile image
Peony4575

My EP told me to take the PIP and to go to hospital if I wasn’t back in NSR in 24 hours

KMRobbo profile image
KMRobbo

I was told by my local hospital go to A&E for sustained AFib over 130 bpm. I generally went about 5- 6 hours after onset.

I was NOT on anti coagulation. So if I needed a DC Cardioversion this had to be done within 48 hours. So appoximate timing was 6 hours in AFib, 1 hour to hospital, 4 hours in A&E given drugs and monitored. If this did not work 1 hour admission to MAU , 6 - 8 hours to be further assesssed and treated with more drugs, 12 hours plus to arrange an anaesthatist for the cardioversion if the drugs did not work. So only a small window to get cardiovered when the anaesthatist was diverted to a more urgent job.

I never actually had a DC cardioversion!

The drugs worked in MAU before the anaesthstist was available most times, the only time this did not happen, the anaesthatist did not turn up/ was not available and having missed the 48 hour window, I spent another 4 days in hospital at resting HR of 165 to 195 bpm, before finally being cardioverted by flecainide infusion in the CCU!

I was very tired by this point and a lot of time was wasted!

Hence why it was necessary to present to hospital early.

It was this experience that prompted me to have an ablation!

And all this was before COVID and NHS crises.

Suesouth profile image
Suesouth

I’ve always been told by paramedics, if rate is high to ring 999. PIP never works for me!

Lainie2875 profile image
Lainie2875 in reply toSuesouth

Good advice

doodle68 profile image
doodle68

So many different experiences and differing advice around the country....

I have by coincidence been in AF and feeling ill twice when attending an arrhythmia clinic, high heart rate, breathless no one seemed concerned. Current details were taken and I was sent home no treatment offered ( already taking a BB and AC)just a suggestion of going on a long list for Ablation .

In January I went to a clinic and spoke to an arrhythmia nurse in despair with episodes happening every couple of days lasting 3-4 days and feeling dreadful heart rate frequently in the 140's ,hot sweats, breathless, so exhausted the stairs are a challenge . I asked when it was appropriate to have mechanical cardioversion and after she consulted with the EP in another room I was told that it was only given when a person had been in AF for over 7 days and unlikely to convert back on their own , that because my AF is paroxysmal I might get to hospital and convert normally while waiting for the cardioversion so not a good idea and there was a 10 week waiting list anyway. I was also told to go home and give Flecainide another try although I had already tried it for a couple of months with awful side effects.

I have absolutely no confident in the care offered in my area to people with AF , I happened to chat to an elderly neighbour recently unaware he also has P-AF, his experience has been similar to mine .

It has been the same for me from day one when eventually an ECG confirmed P-AF, I was shocked having only recently heard of it and the GP I saw gave no information but told me to go home and look it up on my PC also CHADS and HASBLED and to say if I wanted an anticoagulant .

I feel very much on my own, this site is the only help I have had .

I get the impression the medical staff I have seen think AF 'is no big deal 'they just don't understand how ill it can make a person feel.

Lainie2875 profile image
Lainie2875 in reply todoodle68

aw I feel for you I have been in the same place many times.

You will get people who will say “AF won’t kill you “ RUBBISH is my answer to that AF may not kill you but the complications long term untreated AF causes can most definitely kill you .

My AF caused me to have a Heart attack.

And eventually caused Heart failure as I had been left for weeks with AF racing at 150 and above .

Some people are very lucky and the PAF stays just that and is inconvenient but with medication you can jog along and put up with the inconvenience.

Howe ever I that was me for years then Boom !!! It became permanent following a car accident and no matter what treatment I had it would not revert back.

Ended up with and AV node ablation and pacemaker !!!

CDreamer profile image
CDreamer

It is about 10 years since I visited A&E for AF and as we all know, things were very different then. You will get varied advice from people here, I suspect deriving from different personal experiences. NONE of my visits to A&E helped and resulted in just stressing me out. One A&E doctor told me that as I was being treated in outpatient clinic they wouldn’t treat me without consulting my cardiologist - but no-one ever got in touch with him. Needless to say I then decided that I was more comfortable at home so there I stayed.

About 3 times during my worst episodes which had lasted more than 72 hours my husband called an ambulance and paramedics arrived. They did all the monitoring at home, sent ECG through to cardiology to ask should they bring me in, on one occasion they did but on the other occasions they helped with vaso vagal manoeuvres and I reverted to NSR, we all had a nice cup of tea and went on our way. As I say that was all some time ago. An ambulance was called to a neighbour recently and told waiting times were something like 2-4 hours.

At the end of the day it is your decision so if you are worried about your symptoms, have chest pain, are very anxious and just want monitoring and then maybe. My experience in several different hospitals with AF was not good.

I ended up, with help of my GP, writing out criteria of when I should go to A&E, again those were in the halcyon days when you could get to see a GP.

My best advice is - get to see a really good EP - privately for at least one consult. Work out then a plan with them. Be prepared for a AF episodes and know what you are going to do so you don’t panic. This would be my plan:-

Avoid doing any more decorating - for ever.

- Practice breathing exercises LSD - Long, Slow and Deep to stay relaxed.

- Have your PIP at the ready and take it as soon as you feel anything.

- Stay very well hydrated and use some sort of electrolyte drink so ensure if you are peeing a lot, which most of us do, keep electrolytes balanced. I use pure Coconut water. That would be the first thing they would do in A&E anyway - hydrate and electrolyte drip.

- Find some music you enjoy or a good Audible book, get your feet higher than your head and rest and recuperate with phone by your side should you feel the need to contact medical help.

Just my plan, hope it helps.

Steve101 profile image
Steve101 in reply toCDreamer

could you tell me me more about vaso Vagal manoeuvres?

I once got myself to revert by taking a cold shower.

Also interesting that you say take Flecanide as pip when you feel your heart to start to play up. Recently my hear felt ragged and as I thought half hour later I was in AF I have often thought should you take Flecanide as pip when you feel you are going into AF .

This forum is a godsend for people seeking information about AF and just as important some support and empathy .

Steve

secondtry profile image
secondtry

If funds allow pay for a prompt cardiologist appointment. I had one yesterday and after 9+ yrs of 200mgs Flecainide daily and no significant episodes my cardio said if you do get an episode of more than 12 hrs go to A & E. Caution there is no substitute for individual advice, we are all different!

Eric48 profile image
Eric48

I’ve had three ablations but I’ve never been to A&E for treatment! I take propranolol as pill in pocket which seems to be effective.

Ppiman profile image
Ppiman

I always feel that the only safe advice is medical, and based on knowledge of your heart's individual structure and output, gained via ECG, echo and, if possible, MRI. With that, a cardiologist can balance the risks of your sticking out an attack, taking flecainide or a beta-blocker to help bring the rate down, or treating at hospital. I am guessing it's been safely decided that you can sit things out, which is what I suspect most people do and which I do, but I have only ever had >150bpm on one occasion, which did panic me and I did go in, but 5mg bisoprolol was all that was needed to correct things (and maybe the reassurance of medical attention).

When you set your AF off during decorating, as can happen with me, you likely either became stressed and increased your pulse that way, sparking off AF, or physically pulled and pushed your heart around a little by stretching and kneeling down while decorating, which I have also done. Either can send the rate up and cause ectopic beats, and these can spark off AF in prone individuals. If you delayed eating and worked on an empty stomach, I find that that, too, that can add to the stress on the heart.

I hope you're back to normal by now!

Steve

Dudtbin profile image
Dudtbin

when I’ve been worried I’ve rung 111 and found them helpful, we also have a very good urgent care unit near us , they are very laid back and take time to talk to you however busy the waiting room is. I used to ring 111 quite often about my mother and they were helpful. When i rang about my afib they booked me in to an sdec clinic.

Lainie2875 profile image
Lainie2875

Hi

Your GP is atrocious!!!

I suffered with AF for years but when it first started I ignored it as when younger my old GP always said “it’s healthy to get Palpitations “ fgs.

However when it was at its worst and I felt my heart was about to explode I went to local A&E.

I was shocked at the speed in which they dealt with me and was admitted to a ward.

It was then I realised this was not something I should ignore.

Do you take anticoagulation medication as you are high risk of a stroke or Heart attack without this med.

Your heart can only go on so long berating so fast before it starts to get tired and eventually yo are at risk of Heart failure !!!

This all sounds dramatic but trust me despite of what anyone says this is the reality and is exactly what happened to me .

You need follow ups and to see an EP not to be ignored by your useless GPS.

The nhs also ignored me somewhat during Covid and I was told by Arythmia nurse not to go into hospital !! I did go in eventually for other things but was then asked why had I left it so long !!!

Then out of the blue the Heart failure team came and told me I now had Heart failure and this was irreversible.

Eventually after having 3 ablations numerous cardioversions and very medication they could throw at me I had a pace and ablate pacemaker that I am now totally dependent on .

So in answer to your question DO go see someone and if your GP won’t see you complain it’s shocking.

Good luck

MWIC profile image
MWIC

God!!! Thanks for posting and yes it’s shocking that “treatment” for this horrible bloody condition can be so poor

Hate to moan but very Similar experience and total lack of follow-up - I was told you’re on Apixaban that’s the correct treatment nothing else can be done- no mention of btw if you’re HR goes above 150 and stays for more than 10 mins call 999 (told this when I made and got an urgent appt after chatting to a lady on here) and waiting for appt now with consultant- do you think GP’s are just not well-versed in what AFib is and what possible options there are - I’m also on no medication for it and have sat trying to relax with a HR of 180 for 2+ hours at least 4 times in the last month - now I know better (and feel completely stupid for not knowing that trying to keep calm until it goes isn’t the right thing to do) just makes no sense to me

Buffafly profile image
Buffafly in reply toMWIC

Some GPs have no clue 🙄

Hashihilary profile image
Hashihilary

Hello CentreHalfMum, I was prescribed 100mg Flecainide as a PiP following 2 ablations which were only partly successful. My consultant also said that I could instead take 50 mg every day x 2 . After 2 to 3 years, I asked to switch to the daily dose, as my AF was becoming more frequent, IE nearly every day. A good move! I have also started taking magnesium daily, also helpful i think. I am 78, and also am hypothyroid.

Auriculaire profile image
Auriculaire

Definitely no painting again. Paint fumes are poisonous and not just when you are actually painting. They hang around for awhile afterwards. Learn to like "shabby" . Feel virtuous for being greener! Working with arms above head or using a lot of upper body muscles can definitely bring on afib. As CDreamer says you can get used to afib. Mine is nowhere near as symptomatic as it was at first and I think that is partly because I am not so anxious about it. I believe magnesium supplementation has helped with that. I don't even bother using my Kardia anymore. You definitely need to make a fuss about getting yearly liver and kidney function tests on Apixaban. I think your treatment or rather lack of it is shocking. It is one of the reasons I will no longer set foot in the UK - too frightened of getting ill there!

Jetcat profile image
Jetcat

I think it’s how you feel and how worried you are as to wether or not you sit it out at home or visit the hospital.? If you have pain or breathing issues then definitely yes. I have visited hospitals many times over the years with my afib especially in the early days after diagnosis and never ever was I told I shouldn’t be there even though I had no pains or breathing issues.

Sixtychick profile image
Sixtychick

I was told by Leicester Royal Infirmary A&E Doctors, that I should come into A& E. as I get very fast AFib, when I get an episode. It is usually over 150 bpm. They will send me to the heart unit at the Glefield hospital, if it doesn’t stop after a few hours. It is awful when I get it and I could not stop at home with it. I was told I was not being a nuisance and I was the sort of patient they wanted to see.

Quivery profile image
Quivery

This is a strange coincidence. My first ever episode of paroxysmal AF occurred when I was decorating in 2021, but before I got to the painting stage. I was climbing up and down a step ladder filling cracks with Polyfilla with no problem. What may have triggered it was the excessive force I used to squeeze that last little bit out of the tube! But I'll never know. I became faint for a while then felt better, but the PAF continued for about 7-8 hours, captured luckily on ECG at my GP surgery. I'm taking appropriate medication and have had 4 episodes since then. I hope you're feeling better now.

Buffafly profile image
Buffafly

If I do any strenuous work that involves reaching above my head eg pruning a creeper, swimming, I know I will get AF in the next 24 hours. Not immediately, strangely, but happened so often I can be sure it’s a trigger. I thought it was because I have a spinal condition but other people have reported the same.

Buffafly profile image
Buffafly in reply toBuffafly

Regarding your question, my cardiologist told me I could go to A&E if I ‘didn’t feel well’ adding ‘we don’t mind’. My rule based on experience is to go if experiencing regular chest pain/tightness in throat (because that turned out to be ‘heart attack’ caused by coronary artery spasm) or if fast AF continuing for more than 7 days. My usual experience with AF is that it comes at first with ‘waterfall peeing’ and mild diarrhoea and nausea and so I would much rather be at home with my own bathroom!

meg4u profile image
meg4u

Try deep breathing to bring in oxygen and calm the heart for 3 minutes ALSO massaging the heart area helps

CentreHalfMum profile image
CentreHalfMum

Thank you EVERYONE for all your advice and kindness in replying to my post. This forum is not only full of helpful advice but is a great source of comfort. You can feel terribly alone with AF, I think even my lovely husband thinks it’s ‘all a bit of a fuss about nothing much’.

It took about 12 hours after taking PIP for my AF episode to end. My heart/chest always feels woolly and strange the day after taking flecainide, but today I seem fine ( touch wood). So following all your guidance I’m a) going to have a bonfire of all the decorating brushes ….not really, but definitely won’t be painting ever again! B) become that woman from the saying ‘well behaved women never make history’ and get some action from my GP C) if it’s quicker to get an audience with the Pope than see an NHS cardiologist/EP, will go for a private consultation.

I know you all have varying experiences of care, but it’s so sad that we talk about ‘the good old days when you could actually see a GP’ and the impossibility of seeing a consultant on the NHS without years of waiting. I trained as a nurse many years ago and it really saddens me that our health care system is disintegrating. I think it’s more complex than simply underfunding, a change of culture and perhaps, dare I say it, a change in calibre of staff at times? Apologies for being controversial! Thank you all again x

BlueINR profile image
BlueINR

I've had about 18 episodes of afib in the past 2 years. I've not been able to be converted with IV meds (allergic to amiodarone) and have required a cardioversion each time to get into NSR.

I live in the states, so things may be a bit different. Since I thought it unwise to drive myself to an ER and had no one else who could, I called paramedics, emergency services, and each time they took me to the hospial by ambulance and I had cardioversion later that day or the next to get back to NSR.

I always knew when I was in afib: I'd be SOB, have high heartrate usally 130+, and BP on low side, something like 90/50. My cardiologist had told me this was the right thing to do. I don't know what the right thing is for you to do, but it would seem that it would be good for you to seek medical treatment as long as you feel you're having afib.

I'll also add, in the states when paramedics take person to ER, they're not put in waiting room, but taken to a cubicle and seen by an MD at arrival.

Lcubed profile image
Lcubed

I live in USA and have had afib off and on for about 5 years. This past Fall I went into Afib & flutter every day for 2 months. Terrible experience. I had to wait almost 1 month for a conversion and thought that was way too long until I read these posts and it seems our system is much better and faster. The conversion only lasted 3 minutes. I cannot take the drugs due to side effects. Was scheduled for an ablation in January and it was a success. Have had 2 echos since December and tomorrow a stress test as my heart is not pushing out enough blood per beat but still in NSR. I have a regular cardiologist and also an electrophysiology cardiologist and her PA. Before the constant afib I found yoga helped me tremendously. I am over 70 years . Old and have practiced yoga and Qu gong for over 10 years. There are certain easy yoga poses that can help me get back in sinus. My son is a first responder and his suggestions include running your wrists under very cold water for awhile, coughing deeply repeatedly or baring down like going to the bathroom. These are simple things to try and get your heart rate back in sinus. You might try some of these simple things to help while waiting to see a professional, especially yoga. It is never too late to start. Good luck to you.

queseyo profile image
queseyo

Leaving to one side, if “decorating or any other physical or emotional reason triggers an AF episode” you badly need to see a Cardiologist. I have been in similar situations, visiting emergency rooms many times until the hospital suggested I need to see a Cardiologist. Good luck.

doodle68 profile image
doodle68

Unless you have chest pain when in AF you would be unlikely to get an ambulance here ( there is now a list of 999 emergencies on the NHS website ) if you did a long wait is to be expected for the ambulance to arrive , then another long wait in a queuing ambulance to get into A&A, then a long wait in A&E (18 hours recently) to get seen.

I would have to get someone someone to take me to hospital which is not easy ,I wouldn't drive the 40min journey myself when feeling ill with AF , there is nowhere to park in the hospital car park you have queue waiting for another car leaving. I could get a taxi but that is expensive and I would still have a long wait in A&E.

These long waits were common in my local A&E before COVID, the hospital has a poor grading from the CQC and has been in special measures. Not really the hospitals fault, another hospital in the area closed its A&E sending all the patients to a hospital that was already too small to cope.

I try to avoid anxiety when in AF, it puts my already high heart rate up . I need to pee frequent when in AF and to drink regularly to stay dehydrated, not easy on the back of an ambulance, sitting on the floor or on a trolley in A&E.

So unless I have chest pain I stay at home when in AF and can pee and have a drink when I want to and do breathing excercise while staying calm and using distraction techniques .

I don't wish to deter anyone else from going to hospital when in AF , I am just pointing out the state of my local hospital .

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

I have never done the A&E thing or used my St Johns alarm.

Except after Stroke although from 2am awake with a sore head, toileted and went back to sleep. I live alone. I did not look in mirror but at 5.30am I did.

Friends ride it out.

One guy kept working. He was finally ablated in Sept 2021. Two electrical responses were going off together. 100% fixed. No drugs whilst he was on 4 with p.i.p. He had it for 8 years! A success story.

I have rapid persistent AF with stroke then diagnosed with thyroid cancer. Removed. 3rd year scan all clear. I have RAPID PERSISTENT H/R with AF>

I am controlled with CCB Calcium Channel Blocker. Amd Bisoprolol at night.2.5mg.

I say have the pill in pocket but ask what then. You have the Heart Foundation. Ring

them.

Yes a good idea to know in your personal situation.

Remember AT REST LEVEL.

cheri JOY. 74. (NZ)

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